Methylphenidate in Post-Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Diidn't your incompetent? doctor start using methylphenidate over a decade ago?

methylphenidate (7 posts to September 2015)

Methylphenidate, sold under the brand name Ritalin and Concerta, among others, is a central nervous system (CNS) stimulant used in the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy.

 Methylphenidate in Post-Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abinivesh Sathyanarayanan 1 , Sunil Vummiti 2 , Afreen Pudukayil Pudiyamaliyakkal 3

 1. Cardiology, Worcestershire Acute Hospitals NHS Trust, Worcester, GBR 

2. Diabetes and Endocrinology, The Royal Wolverhampton NHS Trust, Wolverhampton, GBR 

3. Medicine and Surgery, Aston University, Birmingham, GBR Corresponding author: Abinivesh Sathyanarayanan, abi2003221@gmail.com 

 Abstract 

 Cerebrovascular disease carries significant morbidity and mortality worldwide. Medical practice has come a long way in optimizing risk factors, managing acute stroke, and preventing recurrence. There are a multitude of complications, ranging from spasticity and neuropathic pain to behavioural changes. The post stroke period typically consists of medical management of symptoms and physical rehabilitation to recover motor function. Many patients also require occupational therapy and holistic support. Therefore, patients who have suffered a stroke require a multi-disciplinary approach to management; this is often lengthy and resource-intensive.(What a fucking joke of a useless line!) There has been much research into interventions aimed at reducing patient morbidity and improving their quality of life. A systematic review of randomized controlled trials and a meta-analysis of results were carried out to assess the effects of methylphenidate, a dopamine and noradrenaline reuptake inhibitor, on post-stroke rehabilitation, keeping in consideration functional outcome measures and effect on mood. Limitations encountered include the quality of studies, small sample sizes, differences in treatment protocol, and varied outcome measures. There is some evidence to suggest methylphenidate may have a positive effect on mood, but there were no significant results to support its use in functional recovery. There is a need for larger trials with more sensitive and standardized outcome measures. Categories: Neurology, Pharmacology, Physical Medicine & Rehabilitation Keywords: methylphenidate (mph), neuro rehabilitation, post-stroke mood disorder, post-stroke recovery, stroke medicine Introduction And Background Stroke remains a leading cause of death and disability, affecting 100,000 people per year in the United Kingdom. This places a significant burden, approximately £3 billion annually, on the NHS, both in its acute management and in dealing with its sequelae [1]. Despite rapid advancements in its prevention and treatment with novel therapies such as Sanbexin® (edaravone and dexborneol), glibenclamide, etc. being studied, research into post-stroke rehabilitation lags behind [2,3]. The ongoing search for pharmacological agents to enhance neuroplasticity and motor recovery post-stroke is a key research area. Various medications and device-based therapies are under investigation. However, currently there are no guidelines on the use of these options to supplement conventional therapy. This systematic review and meta-analysis aim to investigate the use of methylphenidate in rehabilitation after stroke, specifically with motor function. Secondarily, effects on mood and adverse effects of treatment will also be considered. A quarter of strokes occur among the working population; depending on its severity, it may ruin their careers and affect their support network. Managing disability, both physical and psychological, could play a key role in dealing with this [1]. Theory Methylphenidate functions as a CNS stimulant by blocking reuptake of catecholamine transporters, increasing synaptic concentration of noradrenaline and dopamine, and prolonging their effects [4]. One rationale for its use in post-stroke recovery is to counteract post-stroke diaschisis, which includes functional suppression of the catecholaminergic system [5]. Clinical studies suggest that methylphenidate enhances activity in underactive neural networks after stroke, particularly in prefrontal and sensorimotor regions [6]. Subsequent cognitive benefit may be seen across domains such as inattention, working memory, and motivation, which are crucial for effective participation in post-stroke rehabilitation [7]. On a cellular level, pre-clinical studies suggest methylphenidate promotes neuroplasticity by increasing neurite outgrowth, dendritic complexity, and synaptic plasticity. These processes provide a pathway for the structural remodelling that will precede functional recovery, though the application of these findings to humans requires further investigation [8,9]. How to cite this article Sathyanarayanan A, Vummiti S, Pudukayil Pudiyamaliyakkal A (November 17, 2025) Methylphenidate in Post-Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cureus 17(11): e97053. DOI 10.7759/cureus.97053

Long-term treatment with methylphenidate for fatigue after traumatic brain injury

FYI. You'll have to interpret this on your own, I got flagged for whatever comments I made on this post.

Long-term treatment with methylphenidate for fatigue after traumatic brain injury

Stimulant Reduces Apathy in Alzheimer's Disease

 What is your doctor doing to counter the apathy they caused by not having 100% recovery protocols? Your responsibility is to demand a straight answer.

Stimulant Reduces Apathy in Alzheimer's Disease

Twice daily methylphenidate showed modest effect size

by Judy George, Senior Staff Writer, MedPage Today September 27, 2021

Treatment with methylphenidate (Ritalin), a stimulant approved for attention deficit-hyperactivity disorders (ADHD) and narcolepsy, led to a small to medium reduction in apathy in people with Alzheimer's disease, the phase III ADMET 2 trial showed.

At 6 months, methylphenidate 10 mg twice daily led to a larger decrease on the 12-point Neuropsychiatric Inventory (NPI) apathy scale compared with placebo, with a mean difference of -1.25 points (95% CI -2.03 to -0.47, P=0.002), equivalent to a Cohen d of 0.365, reported Jacobo Mintzer, MD, MBA, of the Ralph H. Johnson VA Medical Center in Charleston, South Carolina, and co-authors.

This effect was first seen 2 months after starting treatment and was sustained over 6 months, the researchers wrote in JAMA Neurology.

On the Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change (ADCS-CGIC), a co-primary endpoint, methylphenidate did not show a statistically significant difference over placebo but trended favorably, the researchers noted.

There were no treatment differences in cognitive measures, or in activities of daily living or quality-of-life scores. No new safety signals emerged with methylphenidate treatment.

"Methylphenidate offers a treatment approach providing a modest but potentially clinically significant benefit for patients and caregivers," Mintzer and colleagues wrote. "Clinicians should be aware of the small to medium treatment effects sizes and the lack of effect on activities of daily living."

Apathy affects anywhere from 20% to 90% of people in the dementia stages of Alzheimer's disease, noted Carolyn Fredericks, MD, of Yale University in New Haven, Connecticut, in an accompanying editorial. "Despite the severity of apathy's impact on patients with dementia and their caregivers, it is notoriously difficult to treat, and no therapies to date have proven to be effective," she wrote.

"The magnitude of the effect of methylphenidate reported in this trial is likely to be of clinical significance for many patients and represents the first phase III randomized clinical trial showing efficacy of any treatment for apathy in Alzheimer's disease," Fredericks pointed out.

"While methylphenidate will not be an option for those individuals with medical or psychiatric contraindications to stimulants, the present study demonstrates that it is generally safe and well tolerated for the target population," she added.

Two smaller trials of shorter duration, including the first ADMET study, showed that methylphenidate led to positive outcomes in treating apathy in Alzheimer's disease, with minimal adverse events.

In ADMET 2, Mintzer and co-authors studied 200 patients clinically diagnosed with Alzheimer's disease, mild to moderate cognitive impairment, and frequent or severe apathy from August 2016 to July 2020, assigning 99 participants to methylphenidate 10 mg twice daily and 101 people to placebo.

People with major depression or significant agitation, aggression, delusions, or hallucinations were excluded from the study. Participants had a median age of 76, and two-thirds were men.

Two co-primary outcomes were prespecified: mean change in NPI apathy score and odds of improved ADCS-CGIC rating, both assessed from baseline to 6 months. A significant result for either outcome indicated efficacy.

NPI apathy scores had the largest decrease in the first 100 days, favoring methylphenidate (HR 2.16, 95% CI 1.19-3.91, P=0.01).

At 6 months, ADCS-CGIC ratings improved for 43.8% in the methylphenidate group and 35.2% in the placebo group (OR 1.90, 95% CI 0.95-3.84, P=0.07).

More people in the methylphenidate group reported weight loss of more than 7% during the trial. Of 17 serious adverse events that occurred during the study, none were related to the study drug. No significant differences in the safety profile emerged between treatment groups.

"Many study participants were taking acetylcholinesterase inhibitors, selective serotonin reuptake inhibitors (SSRIs) and other antidepressants, and/or memantine [Namenda] at the time of participation; the authors found no confounding effects of these medications on the study's primary outcomes," Fredericks observed.

"Apathy in the context of Alzheimer's disease often occurs without concomitant depressed mood and is not simply a symptom of depression," she wrote. "That said, depression is also common both in older adulthood and as a neuropsychiatric symptom of Alzheimer's disease, and it can be difficult to untangle which patients are experiencing Alzheimer's disease-related apathy, Alzheimer's disease-related depression, or co-occurring late-life major depression."

ADMET 2 has limitations, Fredericks noted: it did not assess whether methylphenidate meaningfully relieved caregiver burden and relied on "notoriously nonspecific" clinical criteria for Alzheimer's diagnoses, not biomarkers. Future studies should assess methylphenidate treatment on specific forms of apathy, she added.

• Judy George covers neurology and neuroscience news for MedPage Today, writing about brain aging, Alzheimer’s, dementia, MS, rare diseases, epilepsy, autism, headache, stroke, Parkinson’s, ALS, concussion, CTE, sleep, pain, and more. Follow

Disclosures

Funding was provided by the National Institute on Aging.

Mintzer reported being an advisor for Praxis Bioresearch and Cerevel Therapeutics. Other authors reported relationships with NIH, BioXcel Therapeutics, Cerevel, Praxis, Eisai, Kondor Pharma, Eli Lilly, Vaccinex, Functional Neuromodulation, Alzheimer's Therapeutic Research Institute, Alzheimer's Clinical Trials Consortium, Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease, Gerson Lehrman Group, SVB Leerink, Cerevance, Acadia Pharmaceuticals, Sunovion, FDA, Roche, Ono Pharmaceutical, Biogen, Biohaven, Novartis, Janssen, Genentech, Merck, VA, Cadent Therapeutics, Syneos, Avanir Pharmaceuticals, Athira, Alzheon, MapLight Therapeutics, Premier Healthcare Solutions, and IQVIA.

Primary Source

JAMA Neurology

Source Reference: Mintzer J, et al "Effect of methylphenidate on apathy in patients with Alzheimer disease: The ADMET 2 randomized clinical trial" JAMA Neurol 2021; DOI: 10.1001/jamaneurol.2021.3356.

Secondary Source

JAMA Neurology

Source Reference: Fredericks C "Methylphenidate for apathy in Alzheimer disease -- Why should we care?" JAMA Neurol 2021; DOI: 10.1001/jamaneurol.2021.2942.

 

Scientists show cognitive enhancing drugs can improve chess play

Would this be useful for cognitive decline in stroke rehab? We'll never know since nothing seems to be ever followed up to help stroke survivors.

Scientists show cognitive enhancing drugs can improve chess play

06 March 2017 European College of Neuropsychopharmacology (ECNP)

The first study to both show and measure the effects of cognitive-enhancing drugs such as modafinil, methylphenidate (best known under the trade name Ritalin), and caffeine, on chess play is being published in the March edition of the peer-reviewed journal European Neuropsychopharmacology. This shows significant cognitive improvements for modafinil and methylphenidate, and may have influence how these drugs are used off-label in a range of activities.
The study shows how certain drugs can alter and even improve the way in which the brain processes complex information. As applied to chess (and other fields), this supports the possibility pharmaceutical enhancement giving a player a competitive advantage. The World Chess Federation, FIDE, recognised this by introducing an anti-doping code in 20141.
Now a new double-blind randomised controlled trial by scientists from German and Swedish universities has shown that the cognitive enhancing drugs, modafinil, methylphenidate, and caffeine can improve chess play. Previous research had shown that the drugs could improve cognitive performance when a subject was tired or was performing below his or her optimal performance, but this is the first work to show improvement of cognitive performance even if the subject is performing at a very high level.
The team, led by Professor Klaus Lieb (University of Mainz, Germany) gave 39 male chess players controlled doses of one of the drugs modafinil, methylphenidate, caffeine, or a placebo. They then played a series of rapid, time-limited (15 minutes) games against a chess programme (the popular Fritz 12 programme) which had been matched to the strength of each individual player. This was a 4-day “crossover” study, meaning that the player had who taken modafinil on day 1 would receive a different drug (or placebo) on each subsequent day, and so on. In total the researchers gathered data from over 3000 chess games.
“One of the strengths of this study is that the chess programme provides a reference point to measure the cognitive effect”, commented Professor Lieb, “
They found that all three substances tested caused the players to increase the time needed to decide on a move, meaning that more games were lost as the players ran out of time. However, when the analysis was corrected to take out games lost on time, the team found that both modafinil and methylphenidate significantly increased the players’ scores, whereas caffeine showed a more modest, but not statistically significant improvement.
“We were surprised to see that players on the drugs played more slowly than normal, indicating that their thought processes seemed to be deeper” said Professor Lieb.
He continued:
 “The key to this work is in understanding that players showed an improvement if under less time pressure. The results themselves would be pretty significant in chess terms. For example, both modafinil and methylphenidate gave an improvement coefficient of around 0.05.  If we correct for the slowest players, then the effect would be the equivalent of moving a player from say, number 5000 in the world ranking, to number 3500 in the world ranking. In a single game, the effect is the equivalent of having the white pieces, every time, which give around a 5% better chance of winning.
These differences can be pretty significant in a competitive sport or game. But this work also allows us to put a figure on the way that the use of these drugs can affect the way we think in a range of everyday intellectual activities, such as studying for an exam.”
The researchers stress that the use of these drugs as cognitive enhancers are ‘off-label’ uses, and may have significant side effects, especially with repeated use. As all pharmaceutical substances have risks and benefit, there is little data that compares the benefit of cognitive enhancement against any risk or side effect. They also note that this is a comparatively small study, and requires replication before firm conclusions can be drawn.
Trevor Robbins (Professor of Cognitive Neuroscience at the University of Cambridge), who was once ranked in the top 20 chess players in England, commented:
“Chess involves several higher brain processes including working memory, planning, cognitive flexibility and cognitive control. Drugs such as modafinil have previously been found to enhance performance of such cognitive functions in laboratory based studies of non-sleep deprived volunteers, although sometimes at the cost of prolonging response times.
This work, one of the first to study drug effects on chess, shows that these performance enhancements can translate into real-world activities in this study of chess players who improved their performance, though sometimes at the cost of losing on time. ".
Professor Robbins won the Brain Prize in 2014, which is considered the most important international neuroscience prize.
Professor David Nutt (Imperial College), ex-President of the European College of Neuropsychopharmacology, added:
“We have known for decades that stimulants improve sustained performance through reducing fatigue effects on attention and vigilance. So these current data provide new and controlled data in chess - a test of complex cognitive function.  It’s likely that other stimulants could do the same so this does raise interesting issues for regulators of these activities. Clearly more research is needed”
http://www.europeanneuropsychopharmacology.com/article/S0924-977X(17)30019-6/abstract

• Full bibliographic informationTitle: Methylphenidate, modafinil, and caffeine for cognitive enhancement in chess: a double-blind, randomised controlled trial
  
  Journal: European Neuropsychopharmacology March 2017
  
  Authors: Andreas G.Frankea, Patrik Gränsmark, Alexandra Agricola, Kai Schühlea, Thilo Rommel, Alexandra Sebastian, Harald E.Ballóg, Stanislav Gorbulev, Christer Gerdes, Björn Frank, Christianuckes, Oliver Tüschera, Klaus Lieba
  
  
  DOI: 10.1016/j.euroneuro.2017.01.006

Potential of Stimulants to Augment Rehabilitation in the Acute Stroke Setting: Preliminary Support

Maybe these also? This joins marijuana, ecstasy and levodopa as possible help in stroke recovery. 

Potential of Stimulants to Augment Rehabilitation in the Acute Stroke Setting: Preliminary Support 

enny M. Ngo

1

, Michael Korsmo

1

, Karen C. Albright

2,3

, Mansi M. Jhaveri

4,5

,

Ramy E. l. Khoury

1

and Sheryl Martin-Schild

1*

1

Department of Neurology, Tulane University Hospital,

New Orleans, LA 70112, United States.

2

Department of Epidemiology, School of Public Health,

University of Alabama at Birmingham,

Alabama, United States.

3

Geriatric Research, Education, and Clinical Center (G

RECC), Birmingham Veteran Affairs,

Birmingham, Alabama 35233 United States.

4

Department of Physical Medicine and Rehabilitation, Un

iversity of Texas Health Sciences Center at

Houston, Houston, Texas 77030, United States.

5

Department of Neurology, University of Texas Health Scie

nces Center at Houston, Houston,

Texas 77030, United States. 

DOI: 10.9734/INDJ/2016/20621

Editor(s):

(1) Zhefeng Guo, Department of Neurology, Universit

y of California, Los Angeles, USA.

Reviewers:

(1)

Adria Arboix, University of Barcelona, Spain.

(2)

Xing Li, Mayo Clinic, USA.

Complete Peer review History:

http://sciencedomain.org/review-history/11571

Received 1

st

August 2015

Accepted 2

nd

September 2015

Published 27

th

September 2015

Case Study

Ngo et al.; INDJ, 5(1): 1-6, 2016; Article no.INDJ.

20621

2

ABSTRACT

Aims:

The objective of these case studies is to explore the possibility of using neurostimulants

during the acute stage of stroke to facilitate effective rehabilitation of patients with severe strokes.

Presentation of Cases:

In Case 1, methylphenidate was administered to a 63 year old woman with a left anterior cerebral artery infarct who was discharged to inpatient rehabilitation, rather than

original recommendation of skilled nursing facility, prior to returning home. In Case 2, modafinil was administered to a 56 year old man with a left middle cerebral artery infarct who was discharged to inpatient rehabilitation prior to returning home. In Case 3, modafinil was administered to a 66 year old man with a left middle cerebral arery infarct who was discharged to inpatient rehabilitation. In Case 4, modafinil and methylphenidate were co-administered to a patient with a hypertensive intracerebral hemorrhage who experienced an adverse event possibly related to neurostimulants resulting in discontinuation. She was discharged to

inpatient rehabilitation and subsequently to a skilled nursing facility.

Discussion: All cases initially presented to therapists with barriers to inpatient rehabilitation.

Following neurostimulant administration, therapies recommended discharge to inpatient

rehabilitation facility due to improvement in initial barriers. Three out of the four cases tolerated the neurostimulant well, while one case required discontinuation due to an adverse event.

Conclusion: Patients with severe strokes are less likely to meet criteria for inpatient rehabilitation. Depressed consciousness and limited attention are major barriers for which neurostimulants may be of benefit in the acute post-stroke setting. Administration of neurostimulants may improve participation in therapy, thus increasing qualification for inpatient rehabilitation, and ultimately accelerate recovery. Safety data in this population during the acute stage of stroke are lacking.

Exploring the experience of sleep and fatigue in male and female adults over the 2 years following traumatic brain injury: a qualitative descriptive study

If MS fatigue can be figured out and treated then with just the most miniscule amount of stroke leadership we can find the solution to stroke fatigue.

Treatable Causes of Fatigue in Patients with MS

But don't worry nothing will be researched for stroke because there is NO strategy or leadership.

Long-term treatment with methylphenidate for fatigue after traumatic brain injury

Is this a solution? Not mentioned in this research. Why not?

Exploring the experience of sleep and fatigue in male and female adults over the 2 years following traumatic brain injury: a qualitative descriptive study

 

Alice Theadom,1,2 Vickie Rowland,1,2 William Levack,3 Nicola Starkey,4 Laura Wilkinson-Meyers,5 Kathryn McPherson,1,6 on behalf of the TBI Experiences Group
To cite: Theadom A, Rowland V, Levack W, et al. Exploring the experience of sleep and fatigue in male and female adults over the 2years following traumatic brain injury: a qualitative descriptive study. BMJ Open 2016;6:e010453. doi:10.1136/bmjopen-2015010453
▸ Prepublication history and additional material is available. To view please visit the journal (http://dx.doi.org/ 10.1136/bmjopen-2015010453).
Received 4 November 2015 Revised 22 February 2016 Accepted 11 March 2016
For numbered affiliations see end of article.
Correspondence to Alice Theadom; alice.theadom@aut.ac.nz
ABSTRACT
Objectives: To explore the experience of fatigue and sleep difficulties over the first 2 years after traumatic brain injury (TBI). Design: Longitudinal qualitative descriptive analysis of interviews completed as part of a larger longitudinal study of recovery following TBI. Data relating to the experience of fatigue and/or sleep were extracted and coded by two independent researchers.
Setting: Community-based study in the Hamilton and Auckland regions of New Zealand. Participants: 30 adult participants who had experienced mild, moderate or severe brain injury within the past 6 months (&gy;16years of age). 15 participants also nominated significant others to take part. Interviews were completed at 6, 12 and 24months post injury.
Results: Participants described feeling unprepared for the intensity, impact and persistent nature of fatigue and sleep difficulties after injury. They struggled to learn how to manage their difficulties by themselves and to adapt strategies in response to changing circumstances over time. Four themes were identified: (1) Making sense of fatigue and sleep after TBI; (2) accepting the need for rest; (3) learning how to rest and; (4) need for rest impacts on ability to engage in life.
Conclusions: Targeted support to understand, accept and manage the sleep and fatigue difficulties experienced may be crucial to improve recovery and facilitate engagement in everyday life. Advice needs to be timely and revised for relevance over the course of recovery.

Researchers urge caution in prescribing commonly used drug to treat ADHD - Methylphenidate(Ritalin)

Research from 1998 suggests that this might be helpful in stroke rehab. Not that I think any doctor in the world is using it but for us stroke survivors this could have been important if we had a strategy that followed up promising research. But we have crap for stroke leadership.

Methylphenidate(Ritalin) and stroke rehab - 1998

 Researchers urge caution in prescribing commonly used drug to treat ADHD - Methylphenidate(Ritalin)

Authors of new Cochrane Review remain uncertain about effect of widely used medicine on ADHD symptoms, despite large amount of research. Some evidence of increased sleeplessness and loss of appetite leads researchers to encourage more caution in use of methylphenidate.

The Cochrane Library publishes one of the most comprehensive assessments to date on the benefits and harms of a widely prescribed drug used to treat Attention Deficit Hyperactivity Disorder (ADHD).

ADHD is one of the most commonly diagnosed childhood disorders and can continue through adolescence into adulthood. Symptoms include difficulty focusing attention and remaining “on task”, excessively impulsive behaviour, and extreme hyperactivity. It is estimated to affect about 5% of children, and diagnosis is based on clinical judgement rather than objective diagnostic markers.

Methylphenidate, more commonly known by its brand names - Ritalin®, Concerta®, Medikinet®, and Equasym®, amongst others - has been used to treat ADHD for more than 50 years. A team of Cochrane researchers has carefully evaluated and summarized the findings from all of the available randomized trials of this widely used drug.

This new Cochrane Review includes data from 185 randomized controlled trials involving more than 12,000 children or adolescents. The studies were conducted mainly in the US, Canada, and Europe, included males and females from ages 3-18, and all compared methylphenidate with either a dummy pill or no intervention.

When researchers combined data from identified trials, they found that methylphenidate led to modest improvements in ADHD symptoms, general behaviour, and quality of life. Analysis of adverse effects showed that children were more likely to experience sleep problems and loss of appetite while taking methylphenidate. However, the researchers’ confidence in all results was very low: it was apparent from assessing the included trials that it would have been possible for people involved in the trials to have been aware of which treatment the children were taking. In addition, the reporting of results was not complete in many of the trials, and for some analyses there was variation among trial results.

Based upon this information, the researchers urge clinicians to be cautious in prescribing methylphenidate, and to weigh up the benefits and risks more carefully.

The team of 18 researchers was led by Professor Ole Jakob Storebø, Clinical Psychologist from the Psychiatric Research Unit in Region Zealand, Denmark. He says, “This review highlights the need for long-term, large, better-quality randomized trials so that we can determine the average effect of this drug more reliably.”

Co-author Camilla Groth MD added, “This review shows very limited quality evidence for the effects of methylphenidate on children and adolescents with ADHD. Some might benefit, but we still don’t know which patients will do so. Clinicians prescribing methylphenidate must take account of the poor quality of the evidence, monitor treatment carefully, and weigh up the benefits and adverse effects."

Another co-author, Dr Morris Zwi, Consultant Child & Adolescent Psychiatrist added, “This evidence is important for health professionals and parents of children with ADHD. Our expectations of this treatment are probably greater than they should be, and whilst our review shows some evidence of benefit, we should bear in mind that this finding was based on very low-quality evidence. What we still need are large, well-conducted trials in order to clarify the risks versus the benefits for this widely used treatment.”

The researchers have also urged that clinicians and families should not rush to discontinue using methylphenidate. Dr Zwi added, “If a child or young person has experienced benefits without experiencing adverse effects, then there may be good clinical grounds to continue using it. Patients and their parents should discuss any decision to stop treatment with their health professional before doing so.”

An abridged version of the Cochrane Review will appear in the BMJ later this week.
http://doi.wiley.com/10.1002/14651858.CD009885.pub2

• Full bibliographic informationFull citation:"Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD)." Storebø OJ, Ramstad E, Krogh HB, Nilausen TD, Skoog M, Holmskov M, Rosendal S, Groth C, Magnusson FL, Moreira-Maia CR, Gillies D, Buch Rasmussen K, Gauci D, Zwi M, Kirubakaran R, Forsbøl B, Simonsen E, Gluud C. CRG: Developmental, Psychosocial and Learning Problems Group. Cochrane Database of Systematic Reviews 2015, Intervention review. DOI: 10.1002/14651858.CD009885.pub2
  URL Upon publication: http://doi.wiley.com/10.1002/14651858.CD009885.pub2

Randomized Placebo-Controlled Trial of Methylphenidate or Galantamine for Persistent Emotional and Cognitive Symptoms Associated with PTSD and/or Traumatic Brain Injury

Your doctor will need to create a followup study on this. Or a study sponsored by our fucking failures of stroke associations.

Randomized Placebo-Controlled Trial of Methylphenidate or Galantamine for Persistent Emotional and Cognitive Symptoms Associated with PTSD and/or Traumatic Brain Injury`

McAllister TW¹, Zafonte R², Jain S³, Flashman LA⁴, George MS⁵, Grant GA⁶, He F³, Lohr JB⁷, Andaluz N⁸, Summerall L⁹, Paulus MP¹⁰, Raman R³, Stein MB^11,12.

Author information

Abstract

We report findings from a 12-week randomized double-blind placebo-controlled trial of methylphenidate or galantamine to treat emotional and cognitive complaints in individuals (N=32) with a history of PTSD, TBI, or both conditions. In this small pilot study, methylphenidate treatment was associated with clinically meaningful and statistically significant improvement compared to placebo on the primary outcome, a measure of cognitive complaints (Ruff Neurobehavioral Inventory - Postmorbid Cognitive Scale), as well as on the secondary outcomes reflecting postconcussive (Rivermead Postconcussive Symptom Questionnaire) and posttraumatic stress symptoms (Posttraumatic Stress Disorder Checklist). Treatment was well tolerated. These results suggest the need for a larger RCT to replicate and confirm these findings. Design considerations for such a trial should include the need for multiple sites to facilitate adequate recruitment and extension of the treatment and follow-up periods.Neuropsychopharmacology accepted article preview online, 11 September 2015. doi:10.1038/npp.2015.282.